scholarly journals The Relationship Between Out-of-Hospital Airway Management and Outcome Among Trauma Patients with Glasgow Coma Scale Scores of 8 or Less

2011 ◽  
Vol 15 (2) ◽  
pp. 184-192 ◽  
Author(s):  
Daniel P. Davis ◽  
Kent M. Koprowicz ◽  
Craig D. Newgard ◽  
Mohamud Daya ◽  
Eileen M. Bulger ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Airway Management ◽  
Trauma Patients ◽  
Coma Scale ◽  
Scale Scores ◽  
The Relationship

scholarly journals Effects of Not Intubating Non-Trauma Patients With Low Glasgow Coma Scale Scores: a Retrospective Study

2022 ◽  
Vol 2 (1) ◽  
pp. 83-90
Author(s):  
Loui K Alsulimani ◽  
Ohoud Baajlan ◽  
Khalid Alghamdi ◽  
Raghad Alahmadi ◽  
Abdullah Bakhsh ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Clinical Characteristics ◽  
Tertiary Care ◽  
Altered Mental Status ◽  
Trauma Patients ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Coma Scale ◽  
Scale Scores ◽  
Gcs Score

Background: Endotracheal intubation (EI) is a critical life-saving procedure commonly performed on emergency department (ED) patients who present with altered mental status (AMS).  Aims: We aimed to investigate the safety of observing, without EI, patients who present to the ED with decreased levels of consciousness (LOC).  Methods: We reviewed the data of all adult ED patients with a Glasgow Coma Scale (GCS) score ≤ 8, during the period between 2012 and 2018, in an academic tertiary care centre. Trauma patients were excluded. The patients were divided into two groups for comparison: those who were intubated and those who were not. Data on mortality, morbidity, and baseline clinical characteristics were collected and analysed.  Results: After screening 6334 electronic medical records of patients presenting to the ED with decreased LOC, only 257 patients met the inclusion criteria. 173 (67.3%) patients were intubated, while 84 (32.7%) were not. Among the intubated patients, 165 (95.4%) were intubated early (within two hours of presentation). Mortality, morbidity and length of stay for the intubated group were higher, although the baseline clinical characteristics were the same.  Conclusion: It might be safe to observe non-trauma emergency patients with a GCS score ≤ 8 without intubation. However, such decision should be taken carefully, as delayed intubation can be associated with higher mortality and morbidity

scholarly journals Expert-Performed Endotracheal Intubation-Related Complications in Trauma Patients: Incidence, Possible Risk Factors, and Outcomes in the Prehospital Setting and Emergency Department

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Yuko Ono ◽  
Takeyasu Kakamu ◽  
Hiroaki Kikuchi ◽  
Yusuke Mori ◽  
Yui Watanabe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Glasgow Coma Scale ◽  
Airway Management ◽  
Endotracheal Intubation ◽  
Scale Score ◽  
Glasgow Coma Scale Score ◽  
Trauma Patients ◽  
Coma Scale ◽  
Injured Patients

The aim of this study was to determine complication rates and possible risk factors of expert-performed endotracheal intubation (ETI) in patients with trauma, in both the prehospital setting and the emergency department. We also investigated how the occurrence of ETI-related complications affected the survival of trauma patients. This single-center retrospective observational study included all injured patients who underwent anesthesiologist-performed ETI from 2007 to 2017. ETI-related complications were defined as hypoxemia, unrecognized esophageal intubation, regurgitation, cardiac arrest, ETI failure rescued by emergency surgical airway, dental trauma, cuff leak, and mainstem bronchus intubation. Of the 537 patients included, 23.5% experienced at least one complication. Multivariable logistic regression analysis revealed that low Glasgow Coma Scale Score (adjusted odds ratio [AOR], 0.93; 95% confidence interval [CI], 0.88–0.98), elevated heart rate (AOR, 1.01; 95% CI, 1.00–1.02), and three or more ETI attempts (AOR, 15.71; 95% CI, 3.37–73.2) were independent predictors of ETI-related complications. We also found that ETI-related complications decreased the likelihood of survival of trauma patients (AOR, 0.60; 95% CI, 0.38–0.95), independently of age, male sex, Injury Severity Score, Glasgow Coma Scale Score, and off-hours presentation. Our results suggest that airway management in trauma patients carries a very high risk; this finding has implications for the practice of airway management in injured patients.

The relationship between pre-hospital and emergency department Glasgow coma scale scores

Brain Injury ◽  
2003 ◽  
Vol 17 (7) ◽  
pp. 553-560 ◽  
Author(s):  
Jeffrey J. Bazarian ◽  
Melissa A. Eirich ◽  
Steven D. Salhanick
Keyword(s):  
Emergency Department ◽  
Glasgow Coma Scale ◽  
Coma Scale ◽  
Scale Scores ◽  
The Relationship

scholarly journals Galveston Orientation and Amnesia Test: applicability and relation with the Glasgow Coma Scale

2007 ◽  
Vol 15 (4) ◽  
pp. 651-657 ◽  
Author(s):  
Silvia Cristina Fürbringer e Silva ◽  
Regina Marcia Cardoso de Sousa
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Prospective Study ◽  
Trauma Care ◽  
Coma Scale ◽  
Traumatic Amnesia ◽  
Scale Scores ◽  
Post Traumatic ◽  
The Relationship

Restrictions in the application of the Galveston Orientation and Amnesia Test and questionings about the relationship between conscience and post-traumatic amnesia motivated this study, which aims to identify, through the Glasgow Coma Scale scores, when to initiate the application of this amnesia test, as well to verify the relationship between the results of these two indicators. The longitudinal prospective study was carried at a referral center for trauma care in São Paulo - Brazil. The sample consisted of 73 victims of blunt traumatic brain injury, admitted at this institution between January 03rd and May 03rd 2001. Regarding the applicability, the test could be applied in patients with a Glasgow Coma Scale score > 12; however, the end of post traumatic amnesia was verified in patients who scored > 14 on the scale. A significant relationship (r s = 0.65) was verified between these measures, although different kinds of relationship between the end of the amnesia and changes in consciousness were observed.

408: Scene Glasgow Coma Scale Scores Can Help Predict Mortality in Pediatric Blunt Trauma

2008 ◽  
Vol 52 (4) ◽  
pp. S166
Author(s):  
C.B. Irvin ◽  
K.E. Duemling ◽  
T. Oberg ◽  
A.M. Ads
Keyword(s):  
Glasgow Coma Scale ◽  
Blunt Trauma ◽  
Coma Scale ◽  
Scale Scores

Mortality by Decade in Trauma Patients with Glasgow Coma Scale 3

2011 ◽  
Vol 77 (10) ◽  
pp. 1342-1345 ◽  
Author(s):  
Eric J. Ley ◽  
Morgan A. Clond ◽  
Omar N. Hussain ◽  
Marissa Srour ◽  
James Mirocha ◽  
...  
Keyword(s):  
Los Angeles ◽  
Glasgow Coma Scale ◽  
Trauma System ◽  
Mortality Rates ◽  
High Survival ◽  
Trauma Patients ◽  
Coma Scale ◽  
The Third ◽  
Aggressive Care ◽  
Improvement In Survival

The aim of this study was to assess how increasing age affects mortality in trauma patients with Glasgow Coma Scale (GCS) 3. The Los Angeles County Trauma System Database was queried for all patients aged 20 to 99 years admitted with GCS 3. Mortality was 41.8 per cent for the 3306 GCS 3 patients. Mortality in the youngest patients reviewed, those in the third decade, was 43.5 per cent. After logistic regression analysis, patients in the third decade had similar mortality rates to patients in the sixth (adjusted OR, 0.88; CI, 0.68 to 1.14; P = 0.33) and seventh decades (adjusted OR, 0.96; CI, 0.70 to 1.31; P = 0.79). A significantly lower mortality rate, however, was noted in the fifth decade (adjusted OR, 0.76; CI, 0.61 to 0.95; P = 0.02). Conversely, significantly higher mortality rates were noted in the eighth (adjusted OR, 1.93; CI, 1.38 to 2.71; P = 0.0001) and combined ninth/tenth decades (adjusted OR, 2.47; CI, 1.71 to 3.57; P < 0.0001). Given the high survival in trauma patients with GCS 3 as well as continued improvement in survival compared with historical controls, aggressive care is indicated for patients who present to the emergency department with GCS 3.

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